Research indicates that elevated intolerance of uncertainty (IU) is cross-sectionally associated with eating disorder (ED) pathology in women. Although longitudinal data is needed to better understand whether IU is a prospective risk factor for EDs in the general population, IU also influences the performance of athletes, a population at risk for EDs. Despite the relevance of both IU and ED within athletics, research assessing the association of IU and ED pathology in athletes has yet to be conducted. The current study longitudinally explored IU as a potential modifiable risk factor for ED pathology in a sample of women athletes. IU at baseline was hypothesized to predict downstream ED pathology. Participants (N = 393) were women athletes aged 18–39 years from athletic teams/activities across the United States who responded to surveys at baseline and at least one follow-up assessment (3-, 6-, and/or 12-months) as part of a large multi-measure longitudinal study of women athletes. IU and ED pathology were measured using the two-factor, 12-item Intolerance of Uncertainty Scale (IUS-12) and the nine-item Brief Eating Disorders in Athletes Questionnaire (BEDA-Q), respectively. Age-adjusted modified Poisson regression generalized estimating equations (GEEs) examined baseline IUS subscale scores as predictors of subsequent changes in prevalence of a probable ED. The prevalence of a probable ED in this sample was 22.7

Background: Compared to their non-athlete peers, collegiate athletes undergo stressors from both university and sport environments. Unique to collegiate athletes, these stressors often overlap, causing greater opportunities for distress with the COVID-19 pandemic deepening discomfort and uncertainty. Assessing resilience and coping skills during the COVID-19 pandemic could improve future collegiate programs' abilities to boost athletes' capacity to withstand these challenges. Objective: The purpose of this paper was to investigate the presence of coping and resilience and to determine the relationship between different types of coping and resilience in collegiate athletes. Methods: Division 1 collegiate athletes (N = 56) completed online questionnaires including demographic information, the Connor Davidson Resilience Scale (CD-RISC), and the Brief COPE. Results: Higher resilience scores were associated with using higher levels of active coping and acceptance (p < 0.01), and lower levels of behavioral disengagement (p < 0.05). Athlete resilience was predicted by older age and higher use of active/ adaptive coping skills, accounting for 42.2% of the variance (R2= 0.4224. p = 0.0000). Conclusions: This research extends previous research on the relationship between resilience and coping in high performance populations (e.g., U.S. military) supporting the association of increased use of adaptive coping skills with higher resilience. Age was also found to be a significant predictor of resilience in this collegiate athlete population, suggesting noteworthy growth in capacity for change over each year in the athlete experience competing for their university. Future programming should utilize these findings in collegiate athlete training to boost athlete resilience.

Objective Reasons for exercise training are often adaptive (e.g., athletic achievement), but for some athletes, their relationship with training can include a maladaptive desire for weight loss, which can increase risk for eating-disorder pathology. Prior validation of the Athletes' Relationships to Training scale (ART) supported its validity among female athletes. The current study extended this work to compare psychometric properties of the ART among female and male athletes; we expected the measure to perform similarly across sexes. Methods We conducted confirmatory factor analyses (CFA) in the full sample and measurement invariance tests separated by self-reported sex in young-adult athletes from three universities (N = 424, 44.3% male, M[SD]age = 18.9[1.3] years). Pearson correlations tested associations among ART scores with other psychological symptoms to evaluate construct validity, and t-tests evaluated mean group differences in ART scores between males and females. Results The ART's four-factor structure replicated in the full sample, and in males and females separately with good fit. Results from multi-group CFA analyses supported measurement invariance between males and females. There was support for construct validity, such that overall correlations among the ART, maladaptive exercise measures, and eating-disorder pathology were higher relative to correlations with anxiety and depression. Compared to females, males scored significantly higher on the ART total and all subscale scores, with the exception of Body Dissatisfaction. Discussion Results provided preliminary evidence that the ART can be used to assess maladaptive training behaviors among both male and female young-adult athletes, thereby informing interventions designed to improve exercise motivation.

This study aimed to identify potential modifiable risk factors that predict psychological resilience in female athletes and evaluate how well resilience predicts outcomes over time in this group. Three hundred ninety-three female athletes completed demographics and self-report measures at baseline and at least one (3-, 6-, and/or 12-month) follow-up assessment. The Connor-Davidson Resilience Scale 10 and Brief Resilience Scale measured resilience. Hypothesized upstream risk factors included sleep, emotion dysregulation, experiential avoidance, social support, and intolerance of uncertainty. Hypothesized downstream outcomes of low resilience included posttraumatic stress disorder, depression, anxiety, substance abuse, and high perceived stress. Greater emotion regulation difficulties, experiential avoidance, intolerance of uncertainty, social support, and sleep difficulties each significantly longitudinally predicted decreases in resilience over 12 months. Resilience significantly predicted decreases in prevalence of high perceived stress, depression, anxiety, and posttraumatic stress disorder over 12 months. Resilience may be a useful focus of intervention. Difficulties with emotion regulation, experiential avoidance, intolerance of uncertainty, social support, and sleep difficulties are identified as modifiable risk factors and may be targeted in future interventions to enhance resilience in female athletes.

Introduction:This qualitative study aims to elucidate findings from a larger research portfolio exploring the prospective risk and protective factors associated with resilience among women athletes. Methods:Adopting a constructivist approach, semi-structured interviews were conducted with 14 women aged 19-46 years (M = 24 years; SD = 7.64), who represented seven sports and played for an average of 12 years (SD = 5.34). Reflective Thematic Analysis was used to analyze and identify patterns within the data that addressed women's perceptions and experiences of resilience in sport settings, potential barriers and facilitators of resilience, and programmatic preferences for new and/or revised resilience-based trainings. Results:Three overarching themes and seven subthemes were identified: (1) The system breeds adversity and resilience (sports patriarchy and gender inequality; representation and role models; interpersonal dynamics and environments; resilience has ripple effects); (2) misconceptions and stereotypes of resilience; (3) resilience is a dynamic spectrum of interconnected skills (disconnection to attunement with self and others; avoidance to acceptance of adversity; maladaptive to adaptive coping during adversity). Discussion:Findings suggest that traditional resilience models do not account for gendered stressors, structural inequalities, and resilience misconceptions embedded within sports cultures. Results support the need for socio-ecologically informed, gender-responsive approaches to research, clinical practice, and athlete support. Future work should integrate quantitative and qualitative methods into a revised resilience theoretical framework, refine resilience measurement, and prioritize adaptive coping strategies within multi-level frameworks to promote sustainable mental health, well-being, and long-term participation in sport.

ABSTRACT Introduction Psychological resilience has been identified as a potentially modifiable trait/process that may enhance sport performance and athlete mental health. One barrier to improving resilience in female athletes is a lack of longitudinal research identifying upstream modifiable risk factors that can serve as intervention targets. Importantly, the field also lacks sufficient cross-sectional data to inform hypotheses about upstream risk factors. The primary purpose of this study was to address the gaps in both cross-sectional and longitudinal research aimed at enhancing resilience, with a focus on initial cross-sectional findings. This study also investigated whether resilience as assessed was associated with select mental health outcomes. Methods This study cross-sectionally investigated resilience in female athletes ( n = 504). To be eligible, participants had to be female athletes aged 18–45 yr. Participants were recruited for an online survey study via flyers pushed through university athletic departments and other organizations (e.g., ballet companies). Participants were compensated with $25 gift cards. We identified potential modifiable risk factors hypothesized to worsen or improve resilience and correlated them with two measures of resilience commonly used in both the general population and high-performance populations (e.g., military). We also investigated how resilience differed in athletes with clinically meaningful mental health statuses. Results Resilience was significantly correlated with all upstream risk factors (emotion regulation difficulties, experiential avoidance, intolerance of uncertainty, social exchanges, and sleep difficulties). Athletes above and below clinical cutoff scores for depression, anxiety, post-traumatic stress disorder, excessive exercise/body disregard, perceived stress, and drug abuse showed significant differences in resilience; however, no differences were found for elevated female athlete triad risk and probable eating disorder. Conclusion The results of this study need to be extended in longitudinal research that could inform the development of interventions aimed at improving female athlete resilience.

Abstract Purpose: The Veterans Health Administration (VA) created National TeleOncology (NTO) service in 2019 to provide telehealth cancer care to Veterans and to augment care provided at VA facilities through a hub and spoke model. More recently, VA established a Decentralized Clinical Trials (DCTs) infrastructure to support clinical trials (CTs) that rely on telehealth, where research staff are at different locations, and/or where a single IRB provides oversight even when subjects are at different locations. Brief Description: Research support and infrastructure is variable across VA facilities resulting in uneven access to cancer CTs in the VA system. Veterans often live in rural areas or have transportation challenges, which are barriers to participate in CTs. The COVID-19 pandemic resulted in increased telehealth use in clinical care and in CTs, providing the rationale for a focused effort in DCTs. DCTs have the potential to reduce barriers to CT involvement at the facility- and patient-level and may be more representative of real-world clinical scenarios. Summary of Data: Since its inception, NTO has provided hematology and oncology telehealth care to over 10,000 Veterans, of which 47.5% live in rural or highly rural areas, 76.5% are white and 13.2% are black or African American. Because the NTO program provides clinical care via telehealth modalities, patients who receive care through NTO may be more comfortable with participating in CTs that use telehealth, and thus are part of a pool of potentially eligible subjects.Since creation of the DCT program, three cancer DCTs have been conducted in the VA (1) BNT001 Digital Therapeutic Feasibility Pilot Study, (2) Cemiplimab Survivorship Epidemiology (CASE) Study, and (3) Proof-Of-ConcepT DEcentralized CliNical TrIAL (POTENTIAL) study. The BNT study enrolled 24 Veterans, 19 were male, 22 were white, 13 lived in rural areas, and the median age at enrollment was 68 years, including numerous cancer diagnoses. Veterans enrolled in the BNT study received cancer care at seven VA facilities. The CASE study has enrolled 24 male Veterans, 23 were white, 5 lived in rural areas, and the median age at enrollment was 74 years. The POTENTIAL study enrolled 4 male Veterans, 3 were white, 2 lived in rural areas, and the median age at enrollment was 72 years. Upcoming DCTs will focus on the following disease types: metastatic non-small cell lung cancer, multiple myeloma, and relapsed/refractory diffuse large B-cell lymphoma. Conclusions: The VA provides clinical cancer care to Veterans through the NTO program. The DCT program builds upon the existing clinical infrastructure to conduct CTs on a national scale. The NOP DCT team is a component of the VA’s Enhance Equity and Access to Clinical Trials (ENACT) initiative, which is part of Cancer Moonshot. The DCT program intends to expand CT opportunities to Veterans with cancer, minimize barriers to CT activation and enrollment, and improve access to cancer CTs for all Veterans. Citation Format: Ashlyn Press, Jennifer Ordman, Jacqueline Boreland, Zachary Burningham, Shelby Schoenborn, Tiffany Stewart, Bethany Oberg, Perri Pepperman, Holly Morris, Sarah Bloemers, Nawshin Kutub, Shannon Elam, Michael J. Kelley, Daphne Friedman. Veterans Health Administration: Decentralized clinical trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 919.

Emerging research suggests that body dissatisfaction (BD) is prevalent among midlife and older women (i.e., upwards of 70%). Cross-sectionally, BD is associated with myriad poor health and wellness outcomes (e.g., depression, disordered eating, bad nutrition) in midlife/older women. However, relatively few studies have examined the longitudinal relations between BD and health outcomes in this population. This preliminary study investigated the longitudinal associations of BD with wellbeing and health-related quality of life (QOL) among midlife/older adult women over one year. Participants (n = 86, women aged 40–72 years, M = 51.49, SD = 7.34, 86% white) completed self-report measures of BD, psychosocial impairment, health behaviors, and QOL at baseline (T1) and 12-month follow-up (T2). A series of multiple linear regression models included T1 BD as the predictor variable of health outcomes at T2, covarying for T1 BMI and age in all models. BD was associated with greater negative emotions and psychosocial impairment, less physical activity enjoyment, and poorer physical, psychological, and social QOL one year later. Findings suggest that BD is associated with negative consequences for women across the lifespan (ƒ2 ranges = 0.06–0.60). Future research investigating BD as a unique, modifiable risk factor for health outcomes among diverse samples of midlife/older women is warranted. Targeting BD in interventions may improve health indices beyond eating disorders for this population.

The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.

Many patients with chronic lymphocytic leukemia (CLL) experience physical dysfunction and low overall fitness. It remains unknown what factors drive CLL physical dysfunction. We assessed physical function and metabolic lipoprotein panels in 106 patients with CLL. In univariate analyses of clinical factors, a longer time since diagnosis was associated with a higher likelihood of dysfunctional aerobic fitness (OR = 3.56, 95% CI: 1.37–9.22; p = 0.002) and physical performance (SPPB: OR = 2.03, 95% CI: 1.20–3.44; p = 0.004). Having received treatment was associated with a higher likelihood of dysfunctional aerobic fitness (OR = 1.57, 95% CI: 1.02–2.40; p = 0.036), SPPB (OR = 1.85, 95% CI: 1.13–3.03; p = 0.011) and grip strength (OR = 1.67, 95% CI: 1.10–2.55; p = 0.015). We found that several small HDL particle parameters, higher levels of citrate (OR = 2.01, 95% CI: 1.22–3.31; p = 0.030), and lower levels of hemoglobin (OR = 0.50, 95% CI: 0.31–0.82; p = 0.030) were associated with a higher likelihood of dysfunctional aerobic fitness. Multivariable least absolute shrinkage and selection operator (LASSO)-penalized regression analyses using variable importance measures (VIM) showed that 7.8-nm HDL particles (VIM = 1.000) and total HDL particle levels (VIM = 1.000) were more informative than clinical measures for the odds of dysfunctional aerobic fitness and 6-min walk functional fitness, respectively, while 10.3-nm HDL particles (VIM = 0.383) were more informative for grip strength. Time since diagnosis (VIM = 0.680) and having received treatment (VIM = 0.490) were more informative than lipoprotein measures for the odds of having dysfunctional SPPB. Taken together, we establish significant relationships between clinical and metabolic factors and physical characteristics that might prompt early use of ancillary support services.

Chronic lymphocytic leukemia (CLL) is associated with physical dysfunction and low overall fitness that predicts poor survival following the commencement of treatment. However, it remains unknown whether higher fitness provides antioncogenic effects. We identified ten fit (CLL-FIT) and ten less fit (CLL-UNFIT) treatment-naïve CLL patients from 144 patients who completed a set of physical fitness and performance tests. Patient plasma was used to determine its effects on an in vitro 5-day growth/viability of three B-cell cell lines (OSU-CLL, Daudi, and Farage). Plasma exosomal miRNA profiles, circulating lipids, lipoproteins, inflammation levels, and immune cell phenotypes were also assessed. CLL-FIT was associated with fewer viable OSU-CLL cells at Day 1 (p = 0.003), Day 4 (p = 0.001), and Day 5 (p = 0.009). No differences between the groups were observed for Daudi and Farage cells. Of 455 distinct exosomal miRNAs identified, 32 miRNAs were significantly different between the groups. Of these, 14 miRNAs had ≤−1 or ≥1 log2 fold differences. CLL-FIT patients had five exosomal miRNAs with lower expression and nine miRNAs with higher expression. CLL-FIT patients had higher HDL cholesterol, lower inflammation, and lower levels of triglyceride components (all p < 0.05). CLL-FIT patients had lower frequencies of low-differentiated NKG2+/CD158a/bneg (p = 0.015 and p = 0.014) and higher frequencies of NKG2Aneg/CD158b+ mature NK cells (p = 0.047). The absolute number of lymphocytes, including CD19+/CD5+ CLL-cells, was similar between the groups (p = 0.359). Higher physical fitness in CLL patients is associated with altered CLL-like cell line growth in vitro and with altered circulating and cellular factors indicative of better immune functions and tumor control.

Introduction: The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status. Methods: Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine obesity status (with vs. without obesity) and sex as moderators of the relationships between bullying, BE, and BD. Results: On average, adolescents (n = 328) were 12.6 +/- 1.9 y, 45.4% male, 58.2% White, 35.7% Black, and 36.0% had obesity. Obesity status moderated the relationship between bullying experiences and BE, such that these relationships were only significant (B =-0.38, p<.05) among adolescents with obesity compared to adolescents without obesity. In both groups, greater verbal relational bullying experiences were associated with lower BE, while greater physical bullying experiences were related to higher BE only among adolescents with obesity. In adolescent girls without obesity, greater cyberbullying experiences were associated with lower BD. Conclusions: The findings suggest different associations between sub-types of bullying victimization experiences and BE and BD, highlighting the importance of examining these associations separately by obesity status.

Background: Although the link between body dissatisfaction and eating disorder (ED) pathology is well-stablished in general female samples, less is known about correlates of contextual body image (CBI) among female athletes. CBI refers to female athletes experiencing body image concerns in two distinct contexts: sport and daily life (de Bruin et al., 2011). The Contextual Body Image Questionnaire for Athletes (CBIQA) measures four factors of body image (Appearance, Thin-Fat Self-Evaluation, Thin-Fat Others’ Evaluation, and Muscularity) in both contexts. This study sought to A) investigate the psychometric properties of the CBIQA, B) examine the prospective relation of CBI with ED pathology and negative affect among female collegiate athletes, and C) the degree to which CBI prospectively predicts ED pathology and negative affect in female collegiate athletes. Method: Using self-report data collected from a multi-site parent trial, we first examined the psychometric properties of the CBIQA by conducting a confirmatory factor analysis. We assessed construct validity via cross-sectional bivariate correlation analyses with thin-ideal internalization, negative affect, and ED pathology. Lastly, using data collected at Time 1 and 6 months later (Time 2), we investigated the degree to which CBI prospectively predicted ED pathology and negative affect.Results: Results from the CFA largely confirmed de Bruin et al.’s (2011) original factor analysis. Two CBIQA factors (Thin-Fat Self and Appearance) in both contexts correlated with ED pathology and negative affect. Thin-Fat Others also correlated with ED pathology in both domains and negative affect in the sport domain. The Muscularity domain was predominantly orthogonal with other measures. CBIQA factors were uncorrelated with thin-ideal internalization. Finally, when controlling for BMI and Time 1 scores, daily life and sport appearance concerns predicted ED pathology, whereas perceived evaluation of thin-fat by others in the sport context predicted negative affect 6 months later. Conclusions: Results support the psychometric validity of the CBIQA and suggest that this measure appears to capture variance discrete from thin-ideal internalization. The Muscularity factor largely was not related to other outcomes. Further, specific elements of perceived self- and other-evaluation in both contexts is relevant to risk for ED pathology and negative affect. Future research could examine the impact of dual body image between seasons and after transitioning out of sport.Clinical trials registration: NCT01735994

Background: We need new biomarkers that manage CLL patients receiving novel chemotherapeutic agent treatments. In our earlier pilot study, we reported an association of inferior outcomes in those with higher IgM density, or those with IgG isotype expression, not explained by traditional markers such as unmutated IGHV or TP53 aberrations (Brander, et al., ASH abstract 118, 2011). The International Prognostic Index for CLL (CLL-IPI) was developed to provide CLL risk stratification, but this tool was largely studied in those treated conventionally (Lancet Oncol 17:779-790, 2016). Here we report studies of CLL cell IgM expression and outcomes in CLL patients treated with novel agents. We hypothesized that high IgM expression is associated with poor progression free survival (PFS) in patients treated with novel agents.

The physiological and metabolic effects of experimental overfeeding have been extensively studied, yet only few studies have assessed overfeeding effects on eating behaviors and psychological constructs. We analyzed two 8-week overfeeding studies, the PROOF Study (N = 25; 16 males; 16 African American; 24.1 years; 25.1 kg/m(2), inpatient) and the EAT Study (N = 35; 29 males; 20 White; 26.7 years; 25.5 kg/m(2), free-living). In both studies, participants were overfed 40% above baseline (daily) energy requirements for eight weeks, consuming all meals under direct supervision. We assessed eating attitudes and behaviors, eating disorder symptoms, and body image via validated questionnaires and visual analog scales at baseline, week (W) 4, and W8, and at two (PROOF: W16-Post, W24-Post) and three (EAT: W12-Post, W20-Post, W32-Post) follow-up visits, respectively. Hunger, desire to eat, and food cravings (carbohydrates, total cravings) decreased during overfeeding in both studies (all Cohen's d effect sizes >= 0.3, all p <= .048). Depressive symptoms and fear of fatness increased in both studies (all Cohen's d >= 0.4, p <= .020), though they were still within normal limits (t-scores similar to 43-49). Body dissatisfaction increased in both studies during overfeeding (all Cohen's d >= 0.4, all p <= .044) and remained increased during follow-up (PROOF: W16-Post, Cohen's d = 0.9, p = .004; EAT: W12-Post and W20-Post, all Cohen's d >= 0.4, all p <= .037). Overfeeding was associated with some deleterious effects, though most returned to baseline during followup. However, increases in body dissatisfaction remained up to three months post-overfeeding, highlighting the need to address body image disturbance among people who experience weight gain, even if much of the gained weight is subsequently lost.

OBJECTIVE:The Action for Health in Diabetes (Look AHEAD) study previously reported that intensive lifestyle intervention (ILI) reduced incident depressive symptoms and improved health-related quality of life (HRQOL) over nearly 10 years of intervention compared with a control group (the diabetes support and education group [DSE]) in participants with type 2 diabetes and overweight or obesity. The present study compared incident depressive symptoms and changes in HRQOL in these groups for an additional 6 years following termination of the ILI in September 2012. METHODS:A total of 1,945 ILI participants and 1,900 DSE participants completed at least one of four planned postintervention assessments at which weight, mood (via the Patient Health Questionnaire-9), antidepressant medication use, and HRQOL (via the Medical Outcomes Scale, Short Form-36) were measured. RESULTS:ILI participants and DSE participants lost 3.1 (0.3) and 3.8 (0.3) kg [represented as mean (SE); p = 0.10], respectively, during the 6-year postintervention follow-up. No significant differences were observed between groups during this time in incident mild or greater symptoms of depression, antidepressant medication use, or in changes on the physical component summary or mental component summary scores of the Short Form-36. In both groups, mental component summary scores were higher than physical component summary scores. CONCLUSIONS:Prior participation in the ILI, compared with the DSE group, did not appear to improve subsequent mood or HRQOL during 6 years of postintervention follow-up.

PURPOSE: Chronic lymphocytic leukemia (CLL) is the most common leukemia in older adults. CLL patients are at an increased risk of frailty, secondary malignancies, and infectious diseases. The aim of this study was to determine the role of physical fitness and function on biological mediators of tumor control and progression. METHODS: We collected blood from sixty two (68 ± 11 yrs.) men and women with treatment naïve CLL [CLL-IPI: median 1.5 (range: 0-7] and were asked to complete a comprehensive battery of physical fitness and functional tests. The 10 most fit (FIT: estimated VO2peak 34±3 mL/kg/min) and 10 least fit (UNFIT: 25±3 mL/kg/min) adults were matched on age and gender. We completed immunophenotyping of blood leukocytes, NMR-spectroscopy of lipoprotein particles, and sequencing of exosomal micro-RNA (miRNA). The human CLL-like OSU-CLL cell line was co-cultured with autologous plasma and assessed for cell growth and death. RESULTS: The FIT group had 6% fewer CD4+ (p=0.019) and 4% fewer CD8+ (p=0.015) T-cells than the UNFIT group. The FIT group had 15% fewer NKG2A+ NK-cells (p=0.032), and 10% more cytotoxic NKG2A-/KIR+ NK-cells capable of recognizing HLA+ tumor cells. The FIT group had 63% lower concentrations of triglycerides (p=0.025), and 250% fewer large triglyceride rich lipoproteins (p=0.011), and 20% more HDL cholesterol (p=0.04), with no differences for LDL cholesterol. Greater concentrations of triglycerides and large lipoproteins were associated with increased OSU-CLL cell counts (r=0.497, p=0.03) and less OSU-CLL cell death (r=-0.632, p=0.003). A total of 32 miRNA signatures were significantly different between FIT and UNFIT groups (all p<0.05). Of these, 7 distinct miRNAs were positively correlated with OSU-CLL tumor cell growth (e.g. miR-451a: r=0.606, p<0.001), and 6 miRNAs negatively correlated with OSU-CLL tumor cell growth (e.g. miR-24: r=-0.669, p=0.002). CONCLUSIONS: Physical fitness in CLL patients appears to beneficially modify T-cells and NK-cells, plasma lipoproteins and exosomal miRNAs. Certain lipoproteins and miRNAs are associated with tumor cell growth and death. Further studies will hope to define the possible beneficial effects of exercise training for CLL patients. Supported by Internal Duke Funds